Dollars for Docs: Data traces medical funding locally

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ALBANY >> Funding distributed locally by large pharmaceutical companies includes upward of $90,000 to Albany Medical Center researchers to a few hundred dollars for meals.

At Albany Med, the hospital and medical college is also a research institute entity, spokesman Jeffrey Gordon said.

According to data from ProPublica, Albany Med has received more than $92,000 from drug companies Pfizer and Allergan for research in the past four years. Due to confidentiality agreements, specifics about the research could not be discussed, but Gordon said it has involved work regarding neurology, infectious diseases, diabetes, heart failure studies, neuromuscular diseases and irritable bowel conditions such as Crohn’s, IBS and colitis.

“All the research we’re doing is going to support these companies,” Gordon said. The funding, he continued, is for research on behalf of the companies and usually deals with developing safe and effective medications. The monies go toward the cost of testing, infusions, treatments and clinical trials.

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Pfizer funding was for research with heart failure studies, irritable bowel conditions and diabetes, he said.

“The goal is that this will lead to some sort of therapy for chronic illnesses,” Gordon said.

Dr. Manjunath “Amit” Pai received $55,979 from Pfizer in 2012 for research he conducted at Albany College of Pharmacy and Health Sciences.

The funding from the Pfizer grant was used to study the dosing of Tigecycline (marketed as Tygacil) in morbidly obese subjects. Tygacil is an antibiotic used to treat severe infections. Pai was specifically interested in seeing if this medication was being dosed properly for these patients in consideration of their weight. This was an investigator-initiated research grant.

“This is when a researcher submits a proposal to a company requesting funding support for a clinical study,” ACPHS spokesman Gil Chorbajian said. “The potential funding company can ask for clarification, but they cannot modify the proposal in any substantive way — certainly not in any way that might make their product look better.”

If tentatively approved, the study’s clinical protocols, including objectives and methodology, must be submitted and if the protocols are rejected by the Federal Drug Administration it cannot move forward. If it is FDA-approved, there is another review by the Institutional Review Board in studies involving humans.

Chorbajian explained that all studies must be registered at clinicaltrials.gov.

“This ensures anyone can know what is being studied and eventually see the results — regardless of what is learned and whether those results are in the best interests of the drug company,” Chorbajian said.

At the end of the study, the researcher must publish an article in a peer-reviewed journal, and the pharmaceutical company typically has 30 to 60 days to review the article and provide feedback, which the researcher can reject.

“Now, pharmaceutical companies can also pay individuals as consultants or to serve in other roles, but when it comes to funding research, you can see the process receives a good deal of scrutiny, and ultimately, a very high degree of transparency,” Chorbajian said.

In the data gathered by ProPublica, funding can be for “speaking,” “research,” “meals,” “travel” or a combination.

Robert S. Busch with the Endocrine Group of Albany, for example, has either directly or indirectly received more than $250,000 since 2010 — about $35,000 with Brilor Albany as the payee for talks and $170,697 with the Endocrine Group as the payee for research.

“It may look like we’re being wined and dined but a lot of times I’m eating takeout in my car while en route to Syracuse,” said Busch, who was a founding doctor for the Endocrine Group, the second-largest endocrine medical practice in the country, with 18 providers. He estimated the Endocrine Group serves about 10,000 patients annually.

The research, he explained, is separate from the talks he gives. The group has done “quite a few” research studies and clinical trials which can sometimes lead to drug approval by the FDA. The work for clinical trials especially can be time-consuming because patients are using new drugs and need to be routinely monitored. When those patients visit the office, an exam can take more than an hour.

Drugs can be for various situations including people with diabetes and kidney disease, or for people with diabetes who want to lose weight. Another drug is an “innovative insulin in Europe” that patients have the opportunity to get for five years, with everything paid for by the pharmaceutical company.

“This research requires a lot of record keeping and more follow-ups than seeing regular patients. It’s highly regulated,” he said.

The talks, on the other hand, are usually small dinners with other physicians in which background is given about a condition and then there is a promotional part for the drug. Busch said he does these talks throughout the region and the other doctors know he is being paid for his time.

He felt the research was helping because diabetes cases are much different now than they used to be 25 years ago when people with diabetes experienced blindness and kidney problems.

His funding included $46,250 for speaking from Novartis in 2010-2011, and some travel and meals reimbursements. Endocrine Group and Brilor Albany, through Busch, has also received funding from AstraZeneca, Eli Lilly, Merck and Johnson & Johnson.

“It’s a completely different entity and this is due to tremendous progress with drug therapy,” he said.

The Research Foundation of SUNY, at various campuses, has received nearly $250,000 from Pfizer since 2009.

“These payments were made to conduct clinical trials and to help assess the safety and efficacy of the drugs being tested,” a spokesman for SUNY said.

Dr. Joel Kremer, a rheumatologist, was given $27,000 from Pfizer in 2011 for consulting and meals, and then $24,555 by UCB in 2012 for a combination. And Dr. Keith Edwards received $18,100 from Novartis for speaking in 2012. Neurologic Resarch Design in Albany, through Edwards, also received $18,000 for speaking and $5,280 for consulting.

On a smaller scale, Dr. Russell Zivkovich of Cohoes received $857 from AbbVie in 2012 for a combination of services and $271 in meals from Eli Lilly. Dr. Razaali Mamdani of Watervliet received $306 from Forest in 2012 for meals.